Cedar Bend Kennels & Grooming

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Guest Information Form

Pet Info
Pet Name*
Breed*
Gender*
- Male
- Female
Are they altered?*
- Yes, Spayed
- Yes, Neutered
- No
Color*
Age*
Playtime*
- Individual
- Group
Preferred Vet*
Vet Phone #*
Is your dog/cat up to date on the following vaccines?*
please check all that apply.
- Rabies
- Distemper
- Bordetella
Is your dog/cat on flea prevention?*
please check all that apply.
- Yes
- No
Has your dog/cat been groomed before?*
please check all that apply.
- Yes
- No
Feeding Instructions
Amount Per Feeding (cups)*
*
- AM
- MID
- PM
- Free Feed
Medications & Dosing Instuctions
Has your pet been boarded before?*
- Yes
- No
Does your pet have any food allergies?*
- Yes
- No
If yes, explain...*
Is your pet on flea prevention?*
- Yes
- No
If yes, what kind?*
Can your pet receive treats throughout the day?*
- Yes
- No
Has your pet been ill in the past 30 days?*
- Yes
- No
Does your pet have a favorite toy or activity?*
- Yes
- No
List all personal items you will be leaving*
Other Important Information
How long have you had your dog or cat?*
Where did you get him or her from?*
Does your pet have any physical or medical conditions that we should be aware of?*
- Yes
- No
If yes, explain...*
Does your pet exhibit fear toward any of the following?*
please select all that apply.
- N/A
- Storms
- Strangers
- New Places
- Bath Time
- Nail Trims
- Other
If other, explain...*
Socialization (for Dogs)
Has your dog ever bitten a person or another animal causing harm?*
- Yes
- No
- N/A
Does your dog get to socialize with different dogs?*
- Yes
- No
- N/A
Do you go to the dog park?*
- Yes
- No
- N/A
Does your dog like cats?*
- Yes
- No
- N/A
Do you walk your dog?*
- Yes
- No
- N/A
Contact Info
Owner's Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
General Contact Phone*
Emergency Contact Name*
First Last
Emergency Contact Phone*
Where did you hear about us?*
May we use pictures of your pet(s) on our website and Facebook?*
- Yes
- No
All animals must be free of external parasites (fleas and ticks), or they will be treated with a flea and tick bath at the owners expense.

In case of illness or injury, I do hereby give consent for Cedar Bend Kennels to seek treatment from my vet of choice or the closest vet if needed while my pet(s) are being boarded/Groomed at Cedar Bend Kennels. They are to use all reasonable precautions against illness, injury, or escape of my pet(s), and will not be held liable or responsible in any manner, under any circumstances, on account of the care, treatment, or safe-keeping of my pet(s), as it is thoroughly understood that I assume all risks. Should the circumstance arise that my pet(s) remain unclaimed after the date which I have stated as the pick-up date, I understand that written notice will be mailed to the address above. Seven days after such written notice, the pet(s) will be considered abandoned and will become the property of Cedar Bend Kennels to be handled as we deem best. It is further understood that such action will not relieve me from paying all costs of services rendered.
Signature*
Today's Date*
MM slash DD slash YYYY

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Home
Boarding
Day Care
Location
Gallery
Reviews

Cedar Bend Kennels & Grooming

Guest Information Form

Pet Info

Feeding Instructions

Other Important Information

Socialization (for Dogs)

Contact Info

Completed the form?

Get Social